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Objectives: The organization of medical knowledge is reflected in language and can be studied from the viewpoints of semantics and prototype theory. The purpose of this study is to analyze student verbalizations during an Objective Structured Clinical Examination (OSCE) and correlate them with test scores and final medical degree (MD) scores. We hypothesize that students whose verbalizations are semantically richer and closer to the disease prototype will show better academic performance.Methods: We conducted a single-center study during a year 6 (Y6) high-stakes OSCE where one probing intervention was included at the end of the exam to capture students' reasoning about one of the clinical cases. Verbalizations were transcribed and coded. An assessment panel categorized verbalizations regarding their semantic value (Weak, Good, Strong). Semantic categories and prototypical elements were compared with OSCE, case-based exam and global MD scores.Results: Students with Semantic 'Strong' verbalizations displayed higher OSCE, case-based exam and MD scores, while the use of prototypical elements was associated with higher OSCE and MD scores.Conclusions: Semantic competence and verbalizations matching the disease prototype may identify students with better organization of medical knowledge. This work provides empirical groundwork for future research on language analysis to support assessment decisions.